MEDICARE: HA TRINH PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	PT 32469	CA

General Provider Information

NPI Number	:	1154724565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HA TRINH PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	1488 EL CAMINO REAL
Second Line	:	UNIT 208
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-1203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1488 EL CAMINO REAL
Second Line	:	UNIT 208
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-1203
Country	:	US
Telephone Number	:	323-229-1269
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	HA TRINH
Credential	:	PT
Telephone Number	:	323-229-1269

Provider Enumeration Date	:	09/30/2014
Last Update Date	:	08/28/2015

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